7. Pandemic alerting will be a mess thanks to spam, panicked retweets, amateur microbiology and the Baumann Uncertainty Principle.
8. Twitter will never reserve hashtags for sole use by the CDC or FDA or any other public service to guard against spam and keep channels of authority open.
9. Big Pharma will pay out tens of billions of dollars in fines and civil lawsuits related to alleged misleading statements in the course of tweet-marketing.
10. Pharmaceutical company Twitter accounts will be hacked and the exploits will tweet misleading drug information, malicious links, confidential legal settlements and other embarrassing material.
11. Twitter’s curious effects on Dopamine will lead to addictive behaviors interfering with activities of daily living.
12. Healthcare marketers will revert to the traditional broadcast model of marketing after realizing quarterly earnings aren’t immediately boosted by providing free value to the communities they serve.
14. Insurance companies will find and track patients by viewing the follow lists of public-timeline hospital Twitter accounts.
15. Insurance companies will set up dashboards to monitor insureds and use the information profitably.
16. Twitter chats about healthcare reform will be infiltrated by Townhall-like Hashtagging.
17. Patient dignity will be violated by nurses and doctors who tweet about their shifts-from-hell.
18. Big Pharma and medical device companies will pay out tens of billions of dollars in fines (again) years after the FDA decides what regulatory rules to impose on tweeting.
19. Lawyers will set up dashboards to monitor the tweets of pharmaceutical companies, device manufacturers, doctors and healthcare organizations in search of sweet opportunities.
20. Big Pharma will find itself finally engaging with patients on Twitter, only to realize that having 1,550,000 followers on Twitter means having to employ armies of drug safety associates 24/7/365.
21. Twitter chats around specific disease processes will be polluted not only with spam but also misinformation masquerading as evidenced-based medicine.
23. A patient with depression will enter an unstoppable cycle: depressing tweets which lead lead to being un-followed and ignored, leading in turn to more depressing tweets…
24. During a live-tweeted procedure that goes wrong, staff will forget to personally attend and inform the family reading the tweets.
25. Privacy settings in Twitter will be reset to public, either by a Twitter glitch or hack or user-error and patient data will be inadvertently published.
26. Psychotherapists using Twitter to communicate with patients will misinterpret or miss a patient’s tweet, resulting in a suicide.
31. The wrong kind of medical crowdsourcing will led t the wrong diagnostic judgements.
32. Nurses who are not accustomed to the safe use of clinical micro-messaging will be distracted from their bedside duties.
33. Doctors in facilities that employ enterprise micro-blogs may issue the right order to the wrong patient.
34. The wrong laboratory results will be mis-tweeted. Fortunately, a smart nurse will notice the discrepancy between the lab value and the patient’s signs. This time.
35. Patient timelines in facilities using micro-sharing technologies will be confused, causing all sort of mayhem during shifts.
36. The tweets of doctors will be used in courts to contradict testimony regarding timeline claims.
37. The content of doctors’ tweets will be compiled and analyzed to challenge their competencies.
38. Twitter chats about Obsessive-Compulsive Disorder will never end. Twitter chats about Obsessive-Compulsive Disorder will never end. Twitter chats about Obsessive-Compulsive Disorder will never end. Twitter chats about Obsessive-Compulsive Disorder will never end. Twitter chats about Obsessive-Compulsive Disorder will never end.
39. Nurses will lose their jobs for posting TwitPics of patients in undignified positions.
40. Family members will stick their unsolicited noses in each others’ health matters.
41. CDC will inadvertently create panic during a major outbreak after a single malformed tweet is retweeted relentlessly. CNN and Fox News, confusing Twitter with sourcing, will re-broadcast the tweet, fueling more retweets and distortions of the original tweet.
43. Hospitals will monitor their staff’s Twitter streams for violations of confidentiality and other reasons for discipline or termination.
44. Hospitals who don’t understand the subtle dynamics of Twitter-sociology will find themselves in front of public relations nightmares.
45. Healthcare information consumers will be under-served by over-reliance on 140 characters, especially by organizations that don’t have a well-rounded social presence on the web.
47. In a maternity ward, somewhere in the Midwest, the grandparents of twelve girls will read a tweet saying “It’s a boy!”, only to find out someone saw something that wasn’t there.
48. A drug guide application accessible via Twitter’s API will return links to outdated content.
49. Shortly after retweeting the funniest thing she ever read, a newlywed will find out about her husband’s STD.
50. Pharma will receive an unprecedented volume of Warning Letters for its uses of Twitter.
51. A pharmaceutical company will inadvertently issue a drug safety alert about the wrong drug, resulting in billions of dollars in lost sales with a single tweet.
52. A pharmaceutical company will not issue a drug safety alert, resulting in one of the largest class action suits in history since the failure will be retweeted.
53. The FDA will issue a drug safety alert about the wrong drug, resulting in billions of dollars in lost sales with a single tweet.
54. Practices using Twitter for patient care reminders will mix up patient Twitter accounts, causing confused home-care.
55. A psychiatrist being sued for breech of confidentiality on Twitter will be relieved when she discovers that Twitter’s search engine no longer returns her troublesome tweet. Unfortunately for her, the lawyer suing her will find the tweet onFriendFeed’s search.
56. Hospitals who should be blogging or otherwise investing in a larger social media landscape will over-invest in Twitter, since everybody has Dopamine receptors (see #11).
57. Segments of the health care population who aren’t using Twitter will be overlooked or under-served.
59. Patients will increasingly realize that they can tweet adverse events on Twitter. 4Chan will catch on to this too. The big heart of a near-retirement CEO in Big Pharma will enter ventricular fibrillation. He will survive and will be prescribed the medication fictively referred to in #52.
60. David will become internet famous during the next major infectious outbreak. The public, unaware of @CDCemergency, will go to the most logical Twitter name for CDC: @CDC. The confusion will lead to the conclusion that CDC is not on Twitter and will turn to bogus accounts and spammed hashtags for updates. This oversight by CDC and Twitter will go down as one of the biggest failures to capitalize on brand equity.
61. The FDA will finally issue guidance allowing pharmaceutical companies to tweet links to products. Curiously, the FDA will encourage those tweets to be “non-retweetable”, stating that it will use its discretion in fining companies $10,000 for each retweet if, in the FDA’s opinion, the tweet appears “overtly re-tweetable”.
62. The FDA will allow healthcare applications to be built on Twitter’s API. What’s more, the FDA, in its recognition of the importance of real-time technologies in our daily lives, will outline an efficient seven-year approval process for each application.
63. Remarkable healthcare applications will be build on top of Twitter’s API, spurring wider acceptance of twitter in serving the health care needs of the public. Unfortunately, Twitter will make unannounced changes in its API. Jesse Stay, having helped to develop one of the most downloaded Diabetes iPhone apps, will suffer a brain aneurysm while discussing the changes with Twitter. He will survive and recover but will go on to delete his Twitter account and give up application development.
64. The FDA, realizing Twitter’s role in public health, will require pharmaceutical companies and device manufacturers to publicly tweet Serious Adverse Eventswithin 24 hours of receipt of notification. The hypothetical executive referred to in #59, in an extraordinary episode of psychosis, will go postal and use Twitter to live-tweet his rage. From that day onward, the phrase “going postal” will be replaced by “going Twitter”.
65. HIPAA will be repealed and replaced with the Health Insurance Tweetability and Liability for Electronic Records Act of 2010. Among the provisions is the requirement that hospitals with public Twitter profiles not display their Following and Followers on their accounts. Twitter, of course, will offer no way to do this.